REPRESENTATIVES Martin, Beatty, Jerse, Fessler, Olman, Kearns, Jolivette

To amend sections 4755.40 and 4755.48 and to enact

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section 4755.481 of the Revised Code to permit,

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under certain circumstances, the practice of

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physical therapy other than pursuant to the

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prescription or referral of a physician, dentist,

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podiatrist, chiropractor, certified registered

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nurse anesthetist, clinical nurse specialist,

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certified nurse-midwife, or certified nurse

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practitioner.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4755.40 and 4755.48 be amended and	10
section 4755.481 of the Revised Code be enacted to read as	11
follows:	12

Sec. 4755.40.  As used in sections 4755.40 to 4755.56 and	13
4755.99 of the Revised Code:	14

(A) "Physical therapy" means the evaluation and treatment of	15
a person by physical measures and the use of therapeutic exercises	16
and rehabilitative procedures, with or without assistive devices,	17
for the purpose of preventing, correcting, or alleviating any	18
disability. If performed by a person who is adequately trained,	19
physical therapy includes the design, fabrication, revision,	20
education, and instruction in the use of various assistive devices	21
including braces, splints, ambulatory or locomotion devices,	22
wheelchairs, prosthetics, and orthotics. Physical therapy includes	23
the administration of topical drugs that have been prescribed by a	24
licensed health professional authorized to prescribe drugs, as	25
defined in section 4729.01 of the Revised Code. Physical therapy	26
also includes the establishment and modification of physical	27
therapy programs, treatment planning, instruction, and	28
consultative services. Physical measures include massage, heat,	29
cold, air, light, water, electricity, sound, and the performance	30
of tests of neuromuscular function as an aid to such treatment.	31
Physical therapy does not include the medical diagnosis of a	32
patient's disability, the use of Roentgen rays or radium for	33
diagnostic or therapeutic purposes, or the use of electricity for	34
cauterization or other surgical purposes. Physical therapy	35
includes physiotherapy.	36

(B) "Physical therapist" means a person who practices or	37
teaches physical therapy and includes physiotherapist.	38

(C) "Physical therapist assistant" means a person who assists	39
in the provision of physical therapy treatments under the	40
supervision of a physical therapist, or teaches physical therapy	41
under the supervision of a physical therapist, and includes	42
physical therapy assistant.	43

(D) "Supervision" means the availability and responsibility	44
of the supervisor for direction of the actions of the person	45
supervised.	46

Sec. 4755.48.  (A) No person shall employ fraud or deception	47
in applying for or securing a license to practice physical therapy	48
or to be a physical therapist assistant.	49

(B) No person shall practice or in any way claim to the	50
public to be able to practice physical therapy, including practice	51
as a physical therapist assistant, unless the person holds a valid	52
license under sections 4755.40 to 4755.56 of the Revised Code or	53
except as provided in section 4755.534755.56 of the Revised Code.	54

(C) No person shall use the words or letters, physical	55
therapist, physical therapy, physiotherapist, licensed physical	56
therapist, P.T., Ph.T., P.T.T., R.P.T., L.P.T., M.P.T., D.P.T.,	57
M.S.P.T., P.T.A., physical therapy assistant, physical therapist	58
assistant, physical therapy technician, licensed physical	59
therapist assistant, L.P.T.A., R.P.T.A., or any other letters,	60
words, abbreviations, or insignia, indicating or implying that the	61
person is a physical therapist or physical therapist assistant	62
without a valid license under sections 4755.40 to 4755.56 of the	63
Revised Code.	64

(D) No person who practices physical therapy or assists in	65
the provision of physical therapy treatments under the supervision	66
of a physical therapist shall fail to display the person's current	67
license granted under sections 4755.40 to 4755.56 of the Revised	68
Code in a conspicuous location in the place where the person	69
spends the major part of the person's time so engaged.	70

(E) Nothing in sections 4755.40 to 4755.56 of the Revised	71
Code shall affect or interfere with the performance of the duties	72
of any physical therapist or physical therapist assistant in	73
active service in the army, navy, coast guard, marine corps, air	74
force, public health service, or marine hospital service of the	75
United States, while so serving.	76

(F) No person shall practice physical therapy other than on	77
the prescription of, or the referral of a patient by, a person who	78
is licensed in this or another state to practice medicine and	79
surgery, chiropractic, dentistry, osteopathic medicine and	80
surgery, or podiatrypodiatric medicine and surgery, or to	81
practice nursing as a certified registered nurse anesthetist,	82
clinical nurse specialist, certified nurse-midwife, or certified	83
nurse practitioner, within the scope of such practices, and whose	84
license is in good standing, unless either of the following	85
conditions is met:	86

(1) The person holds a master's or doctorate degree from a	87
professional physical therapy program that is accredited by a	88
national accreditation agency recognized by the United States	89
department of education and by the Ohio occupational therapy,	90
physical therapy, and athletic trainers board.	91

(2) On or before December 31, 2003, the person has completed	92
at least two years of practical experience as a licensed physical	93
therapist.	94

(G) In the prosecution of any person for violation of	95
division (B) or (C) of this section, it is not necessary to allege	96
or prove want of a valid license to practice physical therapy or	97
to practice as a physical therapist assistant, but such matters	98
shall be a matter of defense to be established by the accused.	99

Sec. 4755.481. (A) If a physical therapist evaluates and	100
treats a patient without the prescription of, or the referral of	101
the patient by, a person who is licensed to practice medicine and	102
surgery, chiropractic, dentistry, osteopathic medicine and	103
surgery, podiatric medicine and surgery, or to practice nursing as	104
a certified registered nurse anesthetist, clinical nurse	105
specialist, certified nurse-midwife, or certified nurse	106
practitioner, all of the following apply:	107

(1) The physical therapist shall, upon consent of the	108
patient, inform the patient's physician, chiropractor, dentist,	109
podiatrist, certified registered nurse anesthetist, clinical nurse	110
specialist, certified nurse-midwife, or certified nurse	111
practitioner of the evaluation not later than five business days	112
after the evaluation is made.	113

(2) If the physical therapist determines, based on reasonable	114
evidence, that no substantial progress has been made with respect	115
to that patient during the thirty-day period immediately following	116
the date of the patient's initial visit with the physical	117
therapist, the physical therapist shall consult with or refer the	118
patient to a licensed physician, chiropractor, dentist,	119
podiatrist, certified registered nurse anesthetist, clinical nurse	120
specialist, certified nurse-midwife, or certified nurse	121
practitioner, unless either of the following applies:	122

(a) The evaluation, treatment, or services are being provided	123
for fitness, wellness, or prevention purposes.	124

(b) The patient previously was diagnosed with chronic,	125
neuromuscular, or developmental conditions and the evaluation,	126
treatment, or services are being provided for problems or symptoms	127
associated with one or more of those previously diagnosed	128
conditions.	129

(3) If the physical therapist determines that orthotic	130
devices are necessary to treat the patient, the physical therapist	131
shall be limited to the application of the following orthotic	132
devices:	133

(a) Upper extremity adaptive equipment used to facilitate the	134
activities of daily living;	135

(b) Finger splints;

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(c) Wrist splints;

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(d) Prefabricated elastic or fabric abdominal supports with	138
or without metal or plastic reinforcing stays and other	139
prefabricated soft goods requiring minimal fitting;	140

(e) Nontherapeutic accommodative inlays;

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(f) Shoes that are not manufactured or modified for a	142
particular individual;	143

(g) Prefabricated foot care products;

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(h) Custom foot orthotics;

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(i) Durable medical equipment.

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(4) If, at any time, the physical therapist has reason to	147
believe that the patient has symptoms or conditions that require	148
treatment or services beyond the scope of practice of a physical	149
therapist, the physical therapist shall refer the patient to a	150
licensed health care practitioner acting within the practitioner's	151
scope of practice.	152

(B) Nothing in sections 4755.40 to 4755.56 of the Revised	153
Code shall be construed to require reimbursement under any health	154
insuring corporation policy, contract, or agreement, any sickness	155
and accident insurance policy, the medical assistance program as	156
defined in section 5111.01 of the Revised Code, or the health	157
partnership program or qualified health plans established pursuant	158
to sections 4121.44 to 4121.443 of the Revised Code, for any	159
physical therapy service rendered without the prescription of, or	160
the referral of the patient by, a licensed physician,	161
chiropractor, dentist, podiatrist, certified registered nurse	162
anesthetist, clinical nurse specialist, certified nurse-midwife,	163
or certified nurse practitioner.	164

(C) For purposes of this section, "business day" means any	165
calendar day that is not a Saturday, Sunday, or legal holiday.	166
"Legal holiday" has the same meaning as in section 1.14 of the	167
Revised Code.	168

Section 2. That existing sections 4755.40 and 4755.48 of the	169
Revised Code are hereby repealed.	170